A5010472142- Fungal Infections and Studies
- Antifungal resistance and susceptibility
- Autopsy Techniques and Outcomes
- Tuberculosis Research and Epidemiology
- Cervical Cancer and HPV Research
- Viral-associated cancers and disorders
- Global Cancer Incidence and Screening
- Mycobacterium research and diagnosis
- Infectious Diseases and Tuberculosis
- Ovarian cancer diagnosis and treatment
- Lymphoma Diagnosis and Treatment
- Thyroid Cancer Diagnosis and Treatment
- Data-Driven Disease Surveillance
- Infectious Diseases and Mycology
- Diagnosis and treatment of tuberculosis
- Cytomegalovirus and herpesvirus research
- Esophageal Cancer Research and Treatment
- Gastrointestinal disorders and treatments
- Actinomycetales infections and treatment
- Chronic Lymphocytic Leukemia Research
- Parasitic Diseases Research and Treatment
- Syphilis Diagnosis and Treatment
- Nail Diseases and Treatments
- Pneumocystis jirovecii pneumonia detection and treatment
- BRCA gene mutations in cancer
Makerere University
2015-2024
Cornell University
2024
University of California, San Francisco
2024
Indiana University
2024
University School
2024
Indiana University School of Medicine
2024
Uganda Cancer Institute
2022
Kilimanjaro Christian Medical Centre
2020
Mulago Hospital
2012-2016
University of Bahrain
2012-2013
Breast cancer (BC) survival rates in sub-Saharan Africa (SSA) are low part due to advanced stage at diagnosis. As one component of a study the entire journey SSA women with BC, we aimed identify shared and setting-specific drivers BC. Women newly diagnosed multicountry African Cancer-Disparities Outcomes (ABC-DO) completed baseline interview their information was extracted from medical records. Ordinal logistic regression used estimate odds ratios (OR) 95% confidence intervals (CI) for (I,...
Background Information on causes of death in HIV-infected patients Sub-Saharan Africa is mainly derived from observational cohort and verbal autopsy studies. Autopsy the gold standard to ascertain cause death. We conducted an study describe compare clinical contributory findings hospitalized HIV-uninfected Uganda. Methods Between May September 2009 a complete was performed that died combined infectious diseases gastroenterology ward Mulago Hospital Kampala, contributing were based macro-...
In resource-limited areas, such as sub-Saharan Africa, problems in accurate cancer case ascertainment and enumeration of the at-risk population make it difficult to estimate incidence. We took advantage a large well-enumerated healthcare system incidence Kaposi sarcoma (KS), which has become prominent HIV era whose may be changing with rollout antiretroviral therapy (ART). To achieve this, we evaluated HIV-infected adults receiving care between 2007 2012 at any three medical centers Kenya...
Abstract Nodding syndrome (NS) is an epileptic disorder occurring in children African onchocerciasis endemic regions. Here, we describe the pathological changes 9 individuals from northern Uganda who died with NS (n = 5) or other forms of onchocerciasis-associated epilepsy (OAE) 4). Postmortem examinations were performed and clinical information was obtained. Formalin-fixed brain samples stained by hematoxylin eosin immunohistochemistry used to stain astrocytes (GFAP), macrophages (CD68),...
Introduction Interferon-gamma release assays (IGRAs), such as the T-SPOT. TB and QuantiFERON-TB Gold, are commonly used to detect immune responses Mycobacterium tuberculosis (M.tb) identify latent infection. However, their role in reflecting dynamics within tissues, especially absence of active disease, remains unclear. Methods Post-mortem including lung, lymph nodes, spleen, bronchoalveolar lavage, were collected from apparently healthy, HIV-negative road traffic accident victims. M.tb...
Objective The detection of urinary lipoarabinomannan (LAM), a mycobacterial cell wall component, is used to diagnose tuberculosis (TB). How LAM enters the urine not known. To investigate if LAM-positivity result renal TB infection we correlated outcomes LAM-antigen testing histology in an autopsy cohort hospitalized, Ugandan, HIV-infected adults. Methods We performed complete autopsy, including sampling, adults that died during hospitalization after written informed consent was obtained from...
Abstract Fungal infections cause substantial morbidity and mortality. However, the burden of deep fungal is not well described in Uganda. We aimed to estimate etiology histologically diagnosed retrospectively reviewed histology reports at Pathology Reference Laboratory, Department Pathology, Makerere University, Kampala, Uganda from January 1950 September 2019 identify any that had a infection as diagnosis. Over study period, 697 cases were identified with an average incidence 0.73/100,000...
Abstract Microglia provide protection against a range of brain infections including bacteria, viruses and parasites, but how these glial cells respond to fungal is poorly understood. We investigated the role microglia in context cryptococcal meningitis, most common cause meningitis humans. Using series transgenic- chemical-based depletion methods we found that, contrary their protective during other infections, loss did not affect control Cryptococcus neoformans infection which was...
Summary Objective To determine the autopsy acceptance rate and reasons for decline at Mulago Hospital, Kampala, Uganda. Methods The next of kin patients who died in a combined infectious diseases gastro‐enterology ward Hospital were approached to answer questionnaire concerning characteristics their deceased relative. During interview consent was asked perform complete autopsy. If declined, provide reason decline. Results Permission an requested 158 (54%) 290 deaths that occurred during...
Background Diagnosis of pleural tuberculosis (TB) using routinely available diagnostic methods is challenging due to the paucibacillary nature disease. Histopathology and tissue TB culture involves an invasive procedure which requires expertise appropriate equipment, both often unavailable in many health units. Xpert MTB/Rif test has been widely evaluated sputum specimens but data on its performance scarce. We accuracy Cepheid's fluid diagnosis Uganda. Methods Consenting adult patients with...
Fueled by HIV, sub-Saharan Africa has the highest incidence of Kaposi's sarcoma (KS) in world. Despite this, KS diagnosis region is based mostly on clinical grounds. Where biopsy available, it traditionally been excisional and performed surgeons, resulting multiple appointments, follow-up visits for suture removal, substantial costs. We hypothesized that a simpler approach - skin punch would make histologic more accessible. To address we provided training equipment suspected to three HIV...
Minimal invasive but accurate methods to establish the cause of death in HIV-infected patients are needed. We studied agreement between blind and ultrasound-guided needle autopsy complete Uganda.We subsequently performed a followed by adults who died during hospitalization. Two teams pathologists reviewed tissue from either autopsies or formulated major diagnoses, that is, diseases directly contributing death. The primary outcome was concordance diagnosis autopsies.We 96 95 autopsies....
ABSTRACT Point-of-care tests for tuberculous meningitis (TBM) are needed. We studied the diagnostic accuracy of lipoarabinomannan (LAM) lateral flow assay (LFA), LAM enzyme-linked immunosorbent (ELISA), and Xpert MTB/RIF in cerebrospinal fluid (CSF) an autopsy cohort Ugandan HIV-infected adults. obtained written informed consent postmortem from next kin. A complete was done CSF obtained. performed LFA (on unprepared supernatant after heating spinning), ELISA, on samples. Accuracy parameters...
Abstract Background Central nervous system (CNS) compartmentalization provides opportunity for human immunodeficiency virus (HIV) persistence and resistance development. Differences between cerebrospinal fluid (CSF) cerebral matter regarding HIV are well described. However, CSF is often used as surrogate CNS drug exposure, knowledge from solid brain tissue rare. Methods Dolutegravir, tenofovir, lamivudine, efavirenz concentrations were measured across 13 regions plus plasma in samples...
In many resource-limited settings, cryptococcal meningitis (CM) contributes up to 20% of all deaths with further complications due Immune Reconstitution Inflammatory Syndrome (IRIS). We present a case report on patient who developed CMIRIS and then subsequent CM-relapse fluconazole-resistant organism later CM-IRIS once again, manifesting as cystic cryptococcomas, hydrocephalus, sterile CSF. this we, demonstrate that persistent low level infection are not mutually exclusive phenomena. The...
Percutaneous needle autopsy can overcome a number of barriers that limit the use complete autopsies. We performed blind-and ultrasound guided autopsies in HIV-infected adults Uganda. In this study we describe detail methods used, ability both procedures to obtain sufficient tissue for further examination and learning curve operators over time.If written informed consent was granted from next kin, first blind autopsy, puncturing brain, heart, lungs, liver, spleen kidneys using predefined...
Background: Tuberculous meningitis (TBM) has 44% (95%CI 35-52%) in-hospital mortality with standard therapy in Uganda. Rifampicin, the cornerstone of TB therapy, 70% oral bioavailability and ~10-20% cerebrospinal fluid (CSF) penetration. With current WHO-recommended treatment containing 8-12mg/kg rifampicin, CSF rifampicin exposures frequently fall below minimal inhibitory concentration for M. tuberculosis. Two Indonesian phase II studies, first investigating intravenous 600mg second...
The global burden of cervical cancer is concentrated in low-and middle-income countries (LMICs), with the greatest Africa. Targeting limited resources to populations need maximize impact essential. objectives this study were geocode data from a population-based registry Kampala, Uganda, create high-resolution disease maps for prevention and control planning, share lessons learned optimize efforts other low-resource settings.Kampala Cancer Registry records diagnoses between 2008 2015 updated...
Every year, millions of dead people across the globe remain unidentified and are never returned to their families or communities.1Mazzarelli D Milotta L Franceschetti et al.Twenty-five years bodies: an account from Milano, Italy.Int J Legal Med. 2021; 135: 1983-1991Crossref Scopus (6) Google Scholar, 2Reid KM Martin LJ Heathfield Understanding burden a systematic review.Int 2023; 137: 1193-1202Crossref (0) Scholar The circumstances surrounding death often unknown, bodies go unclaimed....
Intussusception is one of the less common causes intestinal obstruction among adults. It usually covert (concealed) in its clinical presentation. The ileo-colic type with accompanying anal protrusion extremely rare. case at hand that both an intussusception protrusion, presence a persistence ascending and descending mesocolons; possibly yet to be documented literature. A 32 year-old African-Ugandan woman presented complaints mass protruding per anus for 2 weeks. was reducible associated...
Histoplasmosis is the most common endemic mycoses among HIV-infected people. Patients with suppressed cell immunity mainly due to HIV are at increased risk of disseminated disease. Dermatological manifestations immune reconstitution inflammatory syndrome (IRIS) and cutaneous histoplasmosis similar an IRIS event have been previously described. We report case a 43-year-old male who presented Histoplasma capsulatum var. 4 months after onset antiretroviral therapy some improvement in...
Intussusception is an uncommon cause of intestinal obstruction in adults. It usually presents with typical features obstruction, and associated the presence a 'lead point' for invaginated portion. This rarely intraluminal, submucosal lipoma.We describe case 64-year-old African-Ugandan woman Bantu ethnicity who presented secondary to intussusception. She was treated operatively. A left colocolonic invagination found interssusceptum having giant polyp. hemicolectomy performed....